Low pre-exposure prophylaxis (PrEP) uptake and high prevalence of sexually transmitted infections among men who have sex with men in Zhejiang Province, China: a large cross-sectional survey

The prevalence of PrEP uptake among MSM in Zhejiang Province remains relatively low. Factors including lower educational level, freelance employment, multiple sexual partnerships, occasional condom use, and rush popper use were correlated with uptake. Importantly, individuals with a history of STIs were more likely to use PrEP, underscoring the need to integrate STI screening into routine PrEP services. These findings provide a critical evidence base for promoting PrEP and for developing tailored HIV/STI prevention strategies targeting MSM.